A patient hospitalized for heart failure exacerbation has been receiving 40 mg furosemide IV twice daily. What statement by the client would alert the nurse to a possible toxic effect of this medication?

My stomach is distended, and I haven't had a bowel movement in 3 days

This IV site seems irritated, it's red and painful

Everything has started sounding muffled, I'm having difficulty hearing

I feel like I've done nothing but urinate since I've been here

Answer and Explanation

The Correct Answer is C

Choice A reason: This choice is incorrect because stomach distension and constipation are not common side effects of furosemide. They may be related to other causes, such as diet, fluid intake, or medication interactions. The nurse should assess the client's abdominal status and bowel habits and provide appropriate interventions, such as increasing fiber, fluids, or laxatives.

Choice B reason: This choice is incorrect because IV site irritation, redness, and pain are not specific side effects of furosemide. They may be caused by other factors, such as infection, infiltration, or phlebitis. The nurse should inspect the IV site and catheter and change them if needed. The nurse should also monitor the client's vital signs and blood cultures for signs of infection.

Choice C reason: This choice is correct because hearing loss or impairment is a rare but serious side effect of furosemide. It can occur due to damage to the inner ear or the auditory nerve. It may be temporary or permanent, depending on the dose and duration of furosemide therapy. The nurse should stop the infusion of furosemide and notify the provider immediately. The nurse should also assess the client's hearing and balance and provide safety measures.

Choice D reason: This choice is incorrect because frequent urination is an expected effect of furosemide. Furosemide is a diuretic that increases the excretion of water and electrolytes through the urine. It helps to reduce fluid overload and edema in clients with heart failure. The nurse should measure and record the client's intake and output and monitor the client's fluid and electrolyte status.

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Correct Answer is A

Explanation

Choice A reason: This choice is correct because captopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause fetal harm or death if used during pregnancy. Captopril can affect the development of the baby's kidneys, lungs, skull, and blood vessels. The nurse should advise the patient to use effective contraception while taking captopril and to inform the provider as soon as possible if she becomes pregnant or plans to become pregnant. The provider may switch the patient to a safer medication for blood pressure control during pregnancy.

Choice B reason: This choice is incorrect because facial swelling is a serious side effect of captopril that may indicate angioedema, a life-threatening allergic reaction that causes swelling of the face, lips, tongue, throat, or airway. The nurse should instruct the patient to stop taking captopril and seek emergency medical attention if she develops facial swelling or any signs of difficulty breathing, such as wheezing, stridor, or cyanosis. Reducing the dose of captopril will not prevent or treat angioedema.

Choice C reason: This choice is incorrect because captopril can be taken with or without food, depending on the patient's preference and tolerance. Food may decrease the absorption of captopril, but this effect is not clinically significant for most patients. The nurse should advise the patient to take captopril at the same time each day, preferably one hour before meals, to maintain consistent blood levels and effects.

Choice D reason: This choice is incorrect because captopril is unlikely to cause anaphylaxis, a severe and potentially fatal allergic reaction that involves multiple organ systems. Anaphylaxis can cause symptoms such as hives, itching, flushing, swelling, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, fast heart rate, and shock. The nurse should instruct the patient to carry an epi pen only if she has a history of anaphylaxis or a severe allergy to another substance. .

Correct Answer is ["5"]

Explanation

To calculate the amount of megestrol oral suspension that the nurse should administer, we can use the following formula:

Amount to administer (mL) = (Desired dose in mg) / (Amount of drug in 1 mL)

Given:

Desired dose = 200 mg

Amount of drug in 1 mL = 40 mg/mL

Now, let's calculate the amount to administer:

Amount to administer (mL) = 200 mg / 40 mg/mL

Amount to administer (mL) = 5 mL

Rounding to the nearest whole number, the nurse should administer 5 mL of the megestrol oral suspension.

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A patient hospitalized for heart failure exacerbation has been receiving 40 mg furosemide IV twice daily. What statement by the client would alert the nurse to a possible toxic effect of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 27 year old female client has a new prescription for captopril. What will the nurse be sure to include in the patient teaching?

Correct Answer is A

Explanation

A nurse is preparing to administer megestrol 200 mg PO to a client. Available is megestrol oral suspension 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["5"]

Explanation

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